ADVANCES IN
Neonatal GERD New studies provide insights into diagnosing, classifying, and treating GERD in infants. by Mary Bates, PhD
and Nationwide Foundation Endowed Chair in Neonatology at Nationwide Children’s Hospital, says that feeding and airway-digestive problems are common in infants but may not always indicate GERD. Ambiguity lies with the definition of troublesome symptoms in newborns or nonverbal patients in general, making it difficult to demonstrate objectively if and when symptoms are truly due to GERD.
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ifferentiating gastroesophageal reflux (GER), which is defined as the passage of gastric contents into the esophagus, from GER disease (GERD), when reflux is associated with troubling symptoms, remains a challenge in infants. Symptom-based diagnosis and treatment of GERD has been in practice widely, and practicing this way is a fundamental problem. Sudarshan Jadcherla, MD, principal investigator, director of the Neonatal and Infant Feeding Disorders Program
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PediatricsNationwide.org | Fall/Winter 2020
As a result, infants are frequently subjected to a battery of empiric therapies, such as prolonged use of acid suppression medications, feeding modifications and positional changes. Now, two new papers from Dr. Jadcherla’s lab provide new evidence-based insights into diagnosing, classifying and treating GERD in infants. In the first study, Dr. Jadcherla and his colleagues used pH-impedance monitoring to differentiate esophageal sensitivity phenotypes in NICU infants referred for GERD symptoms. Symptoms may occur due to esophageal sensitivity to acid, non-acid reflux or other non-GER causes. The researchers documented many symptoms, including vomiting, arching, irritability and
